MC-04-151Miami Shores Village
!Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING LREC�EIVED
Permit No. Pjor 9MY-/61 0041 X° PERMIT APPLICATION aster Permit No.
FBC2001
Permit Type (circle): Building Electrical Plumbing 1Wlechanical Roofing
Owner's Name (Fee Simple Titleholder) Cf° & A I C N u Phone #'' - 1(r S
Owner's Address
City Zip 1.3
Tenant/Lessee Name Phone #
Job Address (where the work is being done) d C?'. -G 1= °1- s 1 .
City _ Nf-4mi Shores Village„ , County Miami -Dade Zip 13
Is Building Historically Designated YES NO
Contractor's Company Name Cgot- 'MJQ Ali A- IC. (0 AL Phone # _ ' (3uT -?
Contractor's Address )1120 Sa.." Cho TWL,
City I State
Qualifier ��r��� �• ���
I NS L
Architect/Engineer's Name (if applicable) Phone #
$ Value of Work For this Permit ` '��I Square Footage Of Work:
Type of Work: ❑Addition Alteration ❑New ❑ Repair/Replace ❑ Demolition
Describe Work: CIO
�Ic 5�STT!xl
Gk
Submittal Fee $ rO Permit Fee $ d CCF $
Notary $ TrainingfEducation Fee $ Technology Fee $
Scanning $ Radon $ Bond $
Code Enforcement $ Structural Plan Review. $
Total Fee Now Due $
(Continued on opposite side)
Bonding Company's Name (if applicable) _
Bonding Company's Address
City State
Mortgage Lender's Name (if applicable)
Zip
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR , LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant. As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged
Signature Signature
er or
The foregoing instrument was acknowledged before me this �� The foregoing instrum acknowledged before me this
day of �r , 20 0`'° • by
who is personally known to me or who has produced ' ' ® Ld
e an oath.
NOTAIR PUBL; '.*__ MY COMMISSION I DD 17
EXPIRES: D9W t 92, M
Sign: flw tVa�ve6�rwts
Print:
day of 20 by
who personally known to _p*or who has produced
_---------
ita ath
,NIII„
NOTARY PUBL : � .: ORESM LUIS
MY COMMISSION # DD 173695
Sign: .. �= EXPIRES: Deomft2a,2006
Print:
My Commission Expires: My Commission moires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
APPLICATION APPROVED BY :°'�% �' / �" y �� �l Plans Examiner
Engineer
Zoning
Chc 10/14/03
. ADDENDUM TO .BUILDING PERMIT APPLICATION
AN APPLICATION FOR BUILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B.
OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.)
PLUMBING ELECTRICAL MECHANICAL
fpm
4TH TUB
UNIT
FEE
ITEM
SWITCH OUTLETS
UNIT
FEE
ITEM
SPACE HEATERS
UNIT
FEE
IDET
LIGHT OUTLETS
CENTRAL HEATING IOy-Li
1
IS•fiyASHER
RECEPTACLES
A/C (WIND)
ISP &
SERVICE TEMPORARY
A/C (CENTRAL) �1�N
IINKING FOUNTAIN
SERVICE SIZE IN AhPS
DUCT WORK
LOOK DRAIN
SERVICE REPAIRAETER CHANGE
REFRIGERATION
REASE TRAP
APPLIANCE OUTLETS
PROCESS AND PRESS PIPING
NTERCEPTOR
RANGE TOP
UNDERGROUND TANKS
AVATCRY
OVEN
ABOVE GROUND TANS
AUNORY TRAY
WATER HEATER
U.F. PRESSURE VESSELS
LOTHES WASHER
WDTORS 0- 1 HP
STEAM BOILERS
MOWER
MOTORS OVER 1- 3 HP
HOT WATER BOILERS
INK, POT /3 COMP.
MOTORS OVER 3- 5 HP
MECHANICAL VENTILATION
;INK, RESIDENCE
MOTORS OVER 5- 8 HP
TRAWORTING ASSEMBLIES
:INK, SLOP
MOTORS OVER 8- 10 HP
ELEVATORS/ESCALATORS
•EM'OiARY WATER CLOSET
MOTORS OVER 10- 25 If
FIRE SPRINKLER SYSTEMS.
AINAL
MOTORS OVER 25-100 HP
COOLING TOWERS
LATER CLOSET
MOTORS OVER 100 FP
VIOLATION
'NDIRECT•WASTES
A/C WINDOW
REINSPECTION
RATER SUPPLY TO:
AIR CONDITIONERS
A/C UNIT
STRIP HEATER
FIRE SPRINKLER
GENERATORS TRANSFORMERS
HEATER -NEW INST.
GENERATORS TRANSFU MERS
HEATER- REPLACE
GENERATORS TRANSFORMERS
LAWN SPRINKLER -WELL
SPECIAL PL RPOSE
SWIMmIND POOL ....
_._.
OUTLETS COlXRCIAL
WATER SERVICE
SIGN TUBES
;EWER CONNECTIONS
SIGN TRANSFORMERS
ITILITY- -SEWER
SIGN TIME CLOCK
ITILITY -WATER
FIXTRIRES
;EPTIC TANK
ANTENNA
IELAY
TELEVISION OUTLETS
)RAINFIELD, 4' TILE/RES.
VIOLATION
W & ABANDON SEPTIC TANK
REINSPECTION
;OAKAGE PIT CU. FT.
,ATCH BASIN
)ISCHARGE WELL
XKSTIC WELL
AREA DRAIN
100E INLET
30LAR WATER HEATER
=IRE STANDPIPE
'OM PIPING
AN SPRINKLER SYSTEM
3AS RANGE
iETER SET (GAS)
BAS PIPING
i 4
0
MIAMI SHORES VILLAGE
BUILDING DEPARTMkN
305- 795 -2204
Building Inspection Request
Date Q y
Type Insp'n t
Permit No. /I (� 0 k4.
Name
Address
Compai
Phone #
Inspection Date
Approved
Correction ❑
Re- Insp'n Fee ❑
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 8/13/2004
Applicant: GEORGE
Owner: GODFREY
JOB ADDRESS: 1035 NE 99
Contractor COOL BREEZE AIR COND CORP
Local Phone: 305 - 226 -2665
Parcel # 1132050190490
Mechanical Permit
Permit Number: MC2004 -151
Page 1 of 1
GODFREY
GEORGE
ST
Contractor's Address: 13120 SW 130 TERR
Legal Description: MIAMI SHORES SEC 8 REV PB 43-67 LOT 13
L
BLK 178 LOT SIZE 110.000 ,
Fees:
Description
Amount
FEE2004 -8248
Building Fee
$150.00
Total Fees: $157. 5
FEE2004 -8249
Technology Fee
$3.75
Total Receipts: $'
FEE2004 -8250
CCF
$3.00
lic
FEE2004 -8251
Training and Education Fee
$1.00
Total Fees:
$157.75
��
Permit Status: APPROVED Permit Expiration: 2/7/2005 Construction Value: $4,705.00
Work: C/O STON A/C SYSTEM
� U - 71
Signed: (INSPECTOR)
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict
conformity with the plans,.drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY:
KS-111
t.
t
LEGEND
®
WOOD
WOOD AREAS
v v v v v v
TILE AREAS
•:;t•: ^• :..•;:•`•.
CONCRETE AREAS
ASPHALT AREAS
A/C -
AIR CONDITIONER
E.M.-
ELECTRIC METER
G.F.E.-
GARAGE FLOOR ELEVATION
LF.E.-
LOWEST FLOOR ELEVATION
—x —x— -
4' HIGH CHAIN LINK FENCE
S.I.P.®
SET 1 12"IRON PIPE
ID.-
IDENTIFICATION
I
SKETCH OF SURVEY .
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NOT V" UNLESS Dams= Will BOUNDARY
SURVEYOR'S SEAL I Hereby Carft, That the aria
LEGAL DESCRIPTION• •. M °}ralm�mvm t�"aoaM�lca1 deeds
!r. ,•a.•••r'• "'° IAt 13 + 7 FLORIDA BOARD OF LAND I
SURVEYOR'S NOTES:
/ 1) Lands shown hereon were not abstracted for easements, right of
way or other Instruments of records.
2).Mom may be additional restrictions not shown in this survey that
-X� may be found in patella reaorde of Miami —Dada County
G 3) No underground improvements won located.
.1Q • 4) Unless otherwise noted, recorded and measured data are In
-4 substantial agreement.
S) Legal description provided by client
6) This survey must, exclusively, be used for mortgage purposes
7) This purvey has been prepared for the exclusive use of the
entities named hereon and the certification hereon does not extend
to any unnamed party.
8) Bearings If shown are based on assumed maridian and Plat of
Record.
9)Elavations based an Dade -- County CBM# 3100 N -397 Elev.- 9.80'
N.G.Y. Datum 1929.
CERTIFIED TO-,.
CARLA I. C
11:14 •t►1 \L MA��-p�r�
�Jlil/JL0 ♦i9111I11 \l ��7���}
:
RROOP & SCHEINHERG, P.A.;
FIDELITY NATIONAL TITLE INSURANCE COMPANY
OF NEW YORK
AHN. AMRO MORTGAGE INC. ITS SUCCESSORS
AND /OR ASSIGNS.
V _ GARY B. CASTEL SURVEYING, INC
ey m
tardi made eets LAND SURVEYORS
l_SL V aL-
in Hlook 178, of "RE BE/D ,Z;AT OF TRACT'S 176A. 1768 1760, 178A, 1788, 1780, 177A, 1778, AND 178A OF 11%17. Fladda AdmWetraun code, Pursuant to
.t�, �i z•..,w,• THE REVISED PLAT OF WADI SHORES SECTION 8" according to the Plat thereof as recorded in Plat Hook 43, at °" 4 �' Fl°�° adilei' 12018 $305)3293 -9720 x(30 MIAMI
2.10 -8 07A X188
Page 87, of the Public Records. of Miami —Dade, County Florida. �-
<
PROPERTY ADDRESS: 1035 N.E. 99th STREET; MIAMI SHORES, FL. 33138. FLOOD zoN6:A
REVISED: GARY B. CASTEL
Regleterad Land S r No 4128 DATE- ' " , JOB No.
State of F da 11 -13 -03 SCALE: ,1 -25 DWN. BY T.H. ?,O� j*f •=